Technische Universität München

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Narcotics are naturally occurring or synthetic drugs which bind to opioid receptors to produce physiological effects. Long term administration of narcotics may result in endocrine side effects as opioid receptors (and endogenous opiates) are involved in the regulation of some hormones.
In humans, the acute administration of opioids in healthy men increase prolactin, hGH, TSH and ACTH secretion but inhibits LH release. Chronic intrathecal administration of opioids has been found to induce central hypocorticism in 15%, growth hormone deficiency in 15% and hypogonadotrophic hypogonadism in almost all patients. Decreased LH, estradiol and progesterone levels, menstrual irregularities including amenorrhea and decreased libido are observed in women receiving intrathecal opioids.
It appears that the impact of opioids on testosterone production depends on the route of administration. Significantly lower testosterone and LH levels are observed after intrathecal administration, but modest or no changes in testosterone have been reported in heroin addicts. However, decreased libido and impairment of spermatogenesis have been observed in male patient receiving intrathecal opioids as well as in addicts.
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